M-anticholinergics include substances that block m-cholinergic receptors in the region of the endings of parasympathetic nerve fibers, resulting in dilated pupils, accommodation paralysis, tachycardia, improved AV conduction, decreased tone of the bronchi, bladder, weakening of intestinal motility, decreased secretion of glands (bronchial and digestive). Some alkaloids (atropine, scopolamine), a number of semi-synthetic and synthetic compounds have m-anticholinergic activity. In addition to alkaloids, belladonna, dope, and henbane preparations are used. Extracts and tinctures of belladonna containing alkaloids (hyoscyamine, scopolamine, etc.) are used as antispasmodic and analgesic agents for stomach diseases, gallstone disease, as well as for spasm of smooth muscles (various types of colic), bradycardia associated with overexcitation n.vagus. In the form of a dry extract, belladonna alkaloids are included in many complex tablets: Besalol, Bellastezin. From the leaves of datura and henbane, oils are obtained, which serve as the basis for the manufacture of liniment for external use in neuralgia, myositis and rheumatoid arthritis. The difference in the chemical structure (the presence of quaternary or tertiary nitrogen atoms, etc.) determines not only the predominance of the receptor effect, but also the penetration through the BBB (the presence of a central effect), the duration of action and other properties, which ultimately leads to the differentiation of indications for use. .. Natural alkaloids and many m-cholinolytic agents related to tertiary amines are well absorbed in the intestine, pass through the conjunctival membrane and other histohematogenous barriers, and penetrate into various tissues and organs after absorption from the injection site. Quaternary ammonium compounds (methocinia iodide, fubrogonia iodide, etc.) do not pass through the BBB and are used as peripheral anticholinergic agents.
In recent years, subtypes of m-cholinergic receptors (mone, m2, m3) and drugs of selective action (pirenzepine, ipratropium bromide, etc.) have been created, which have found application in diseases of the gastrointestinal tract and bronchial asthma.
In addition to the listed groups of compounds, antihistamines, antipsychotic and antidepressants also have anticholinergic activity, because have a similar chemical structure.
Below is a list of m-anticholinergics:

  • Ipratropium bromide
  • Atropine (Atropinum)
  • Hyoscine butylbromide (Hyoscini butylbromidum)
  • Solifenacin
  • Pirenzepine
  • Tolterodine
  • Oxybutynin
  • Umeclidinium bromide
  • Belladonna leaves (Folia Belladonnae)
  • Methocinia iodide
  • Tropicamide
  • Pitofenone
  • Platyphyllinum (Platyphyllinum)
  • Priphinium bromide
  • Glycopyrronium bromide
  • Trospium chloride
  • Tiotropium bromide
  • Dicycloverine
  • Troventol (Troventolum)
  • Fenpiverinium bromide
  • Cyclopentolate